肺结核及合并细菌性肺炎患者血清脂类分析

发布时间：2018-06-18 14:39

本文选题：结核/肺 + 肺炎　；参考：《重庆医科大学学报》2017年03期

【摘要】：目的:研究肺结核、肺结核合并细菌性肺炎患者血清脂类特征及与痰涂片结果的相关性。方法:研究对象来自山东省潍坊市第二人民医院,共3组:入院治疗的肺结核患者460例(单一结核组),肺结核合并细菌性肺炎患者315例(结核合并肺炎组),同期健康体检者434例(健康对照组)。抽取研究对象清晨空腹血,离心后检测血清总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、脂蛋白a(lipoprotein(a),Lp(a))、载脂蛋白A1(apoprotein A1,Apo A1)、载脂蛋白B(apoprotein B,Apo B)的含量。TC、TG采用酶法测定;HDL-C、LDL-C采用选择性遮蔽直接法测定;Lp(a)、Apo A1、Apo B采用免疫透射比浊法测定。收集患者即时、夜间、次日清晨9份痰液,做抗酸染色镜检,结果用--、1+、2+、3+、4+表示。结果:(1)与健康对照组相比,单一结核组TC、TG、HDL-C、LDL-C、Apo A1、Apo B降低(Z值分别为-5.941、-3.733、-4.170、-6.213、-4.557、-4.022,P值均小于0.001),Lp(a)升高(Z=-2.399,P=0.016);(2)与健康对照组相比,结核合并肺炎组TC、TG、HDL-C、LDL-C、Apo A1、Apo B降低(Z值分别为-6.894、-3.676、-5.796、-6.287、-5.799、-4.321,P值均小于0.001),Lp(a)升高(Z=-2.888,P=0.004);(3)与单一结核组相比,结核合并肺炎组TC、HDL-C、LDL-C、Apo A1降低(Z值分别为-5.624、-4.169、-2.237、-4.328,P值分别为0.000、0.000、0.025、0.000);(4)单一结核组痰涂片结果与Apo A1相关(rs=-0.319,P=0.000),结核合并肺炎组痰涂片结果与HDL-C、Apo A1相关(rs值分别为-0.175、-0.302,P值分别为0.002、0.000)。结论:(1)血清TC、TG、HDL-C、LDL-C、Lp(a)、Apo A1和Apo B可辅助诊断肺结核;(2)TC、HDL-C、LDL-C、Apo A1可区分肺结核、肺结核合并细菌性肺炎两种疾病;(3)Apo A1有望成为肺结核患者病情严重程度的诊断标准,HDL-C、Apo A1有望成为肺结核合并细菌性肺炎患者病情严重程度的诊断标准。
[Abstract]:Objective: To study the serum lipid characteristics and the correlation with the results of sputum smear in patients with tuberculosis, tuberculosis and bacterial pneumonia. Methods: the subjects were from the second people's Hospital in Weifang, Shandong province. There were 3 groups of tuberculosis patients (single tuberculosis group), 315 cases of tuberculosis combined with bacterial pneumonia (tuberculosis combined with pneumonia group). In the same period, 434 healthy subjects (healthy control group) were tested for the morning empty blood. After centrifugation, serum total cholesterol (total cholesterol, TC), triglyceride (triglyceride, TG), high density lipoprotein cholesterol (high density lipoprotein cholesterol, HDL-C), low density lipoprotein cholesterol (low density) Rol, LDL-C), lipoprotein a (lipoprotein (a), Lp (a)), apolipoprotein A1 (apoprotein A1, Apo A1), apolipoprotein determination. The results were as follows: (1+, 2+, 3+, 4+). Results: (1) compared with the healthy control group, the single tuberculosis group was TC, TG, HDL-C, LDL-C, Apo A1, and Apo B. (2) compared with the health control group, the tuberculosis combined pneumonia group was compared. HDL-C, LDL-C, Apo A1, Apo B decreased (Z values are -6.894, -3.676, -5.796, -6.287, -5.799, values are less than 0.001). The results of sputum smears in a tuberculosis group were associated with Apo A1 (rs=-0.319, P=0.000), and the results of sputum smears in the group of tuberculosis combined with pneumonia were associated with HDL-C, Apo A1 (RS values were -0.175, -0.302, P are 0.002,0.000). Tuberculosis combined with two diseases of bacterial pneumonia; (3) Apo A1 is expected to be a diagnostic criterion for the severity of tuberculosis patients. HDL-C and Apo A1 are expected to be the diagnostic criteria for the severity of TB patients with bacterial pneumonia.
【作者单位】：潍坊医学院医学检验学系;潍坊医学院临床医学院;
【基金】：国家自然科学基金资助项目(编号:81470001)
【分类号】：R521;R563.1;R446.1

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